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Biomedical subjects

D Zdrenghea

Publications and source records attributed to D Zdrenghea.

At least 19 recordsLinked to original sources
PubMed1996

[Left diastolic ventricular function, systolic blood pressure and erythrocyte magnesium in young type I diabetics].

Early cardiac involvement has been reported in type I diabetes mellitus. This study was undertaken to evaluate the relationship of systolic blood pressure (SBP), erythrocyte magnesium (MgE) and left ventricular diastolic function (LVDF). Forty-four patients with insulin-dependand diabetes (IDD) aged 26 to 31 years, without apparent cardiac complications 8.5 +/- 6 years after the onset of disease were studied. They were compared with 20 healthy subjects of the same age who comprised the control group. Left ventricular diastolic function was evaluated by isotopic technetium 9m ventriculography with a Gamma-Picker scintilation chamber, by determining maximum left ventricular filling velocities (I, VFmax). The MgF was measured by EDTA titrimetry. Patients were divided into two subgroups depending on the SBP: Group A (20 patients) with a mean SBP of 136 +/- 4.2 mmHf and Group B (24 patients) with a mean SBP of 118 +/- 4.4 mmHg; the control group had a mean SBP of 110 +/- 4.4 mmHg. The following results were obtained. [table: see text] The authors conclude that even small increases of SBP may, with a decrease in Mg, be a risk factor for early cardiac complications in IDD in young adults.

Adult↗
PubMed1976

Increased serum gamma-glutamyltransferase in hypertriglyceridemia: comparison with serum pseudocholinesterase.

Both gamma-glutamyltransferase (gammaGT) and pseudocholinesterase (PCE) were found to be increased in hypertriglyceridemic subjects. High values of gammaGT were noted in alcoholic subjects and especially in those with either increased serum triglyceride or alanine aminotransferase higher than 16 mU/ml, while PCE was not significantly changed in alcoholic subjects. Although both enzymes were strongly correlated with the logarithm of serum triglyceride and the prebeta electrophoretic fraction, there were striking differences concerning their behavior in various hypertriglyceridemic subjects. PCE activity was high even in moderate hypertriglyceridemias but its correlation with serum triglyceride had a tendency to flatten with increasing concentration of triglyceride. However, increase of gammaGT was rather characteristic for gross hypetriglyceridemia. Short-term, triglyceride-lowering therapy was accompanied by a tendency to normalization of gammaGT, while PCE values were not influenced. An attempt was made to interpret these changes of serum-enzyme activity in hypertriglyceridemia in connection with mechanisms of lipoprotein synthesis and with the pathogeny of hyperlipemic conditions.

Adult↗
PubMedDate not supplied

Essential arterial hypertension and polymorphism of angiotensinogen M235T gene.

Several candidate genes, chosen from the renin- angiotensin system, were examined for their association with essential hypertension. The genes of the renin- angiotensin system (RAS) are good candidates for such an approach because this system is well known to be involved in the control of blood pressure. One of these candidate genes is the gene encoding for angiotensinogen (the most important gene of the RAS associated with essential hypertension in the most population, is the gene for angiotensin-converting enzyme- ACE). One DNA polymorphism within exon 2- with threonine instead of methionine at position 235 (M235T) was found to be significantly associated with hypertension. The objective of this study is the analysis of M235T polymorphism in angiotensinogen gene in Romanian patients with essential hypertension as well as controls. We examined 38 patients with essential hypertension and 21 normotensive patients. In order to identify the M235T angioteninogen variant, we used the following methods: DNA extraction, PCR amplification and enzymatic digestion of the PCR product using Tth 111I restriction endonuclease enzyme. In the study groups, the M235T variant (Met?Thr in aminoacid position 235) was found more frequently in hypertensive patients (81,57%), than in control subjects (66,66%). We identified 52,63% M235T heterozygotes in the hypertensive group compared with 47,61% in the control group, and 28,94% T235T homozygotes in the hypertensive group compared with 19,04% in the control group. The results of our study suggest an association of the M235T polymorphism in the gene encoding angiotensinogen with essential hypertension.

Adult↗
PubMedDate not supplied

Correlation between left ventricular diastolic function and exercise testing in patients with old myocardial infarction.

There is no correlation between left ventricular (LV) systolic function and effort capacity of the patients with acute or old myocardial infarction (MI). On the other hand, some recent studies suggest such a relationship for LV diastolic function. Twenty-five patients with old MI were submitted to a maximal symptoms limited exercise testing (ET) and to an echo Doppler examination; functional aerobic impairment (FAI), myocardial aerobic impairment (MAI), maximal exercise capacity (METs NYHA class), isovolumic relaxation time (IVRT), E and A wave velocity, E/A rate being calculated. There is a negative significant correlation between MAI and E velocity (r = -0.68), but not between MAI and A velocity or IVRT. The data sustained the correlation between LV diastolic dysfunction and myocardial ischemia, but not with effort capacity of the patients, the last one being determined mainly by other factors. The LV diastolic function indices were modified in anterior but not in inferior MI, in relation with the amount of myocardial necrosis. It is concluded that, like LV systolic function, LV diastolic function does not correlate with the effort capacity of the patients with MI, but it represents a good predictor of the severity of myocardial ischemia mainly in anterior MI.

Diastole↗
PubMedDate not supplied

Effect of exercise training upon left ventricular systolic performance and effort capacity in patients with old myocardial infarction.

Recent studies suggested an improving of left ventricular (LV) systolic function during exercise training in patients with old myocardial infarction. Twenty patients with old myocardial infarction (3-6 weeks) were included in an exercise training programme (mainly cycloergometer) for 2 to 8 weeks. Before and after the exercise training programme, the effort capacity and LV systolic function were determined through exercise testing on cycloergometer and echocardiography. The peak effort raised from 4.39 to 5.27 METs (p < 0.05) and the difference DAF-DAM was reduced from 25% to 12% (p < 0.05). The double product (DP) at peak effort raised nonsignificantly (4.91%, p > > 0.05), but at submaximal effort levels DP decreased significantly on each effort step (12.16%, p < < 0.05). In turn, LV systolic function calculated parameters were practically the same before and after the exercise training programme. (EDD 54.3 vs 5.3 mm, ESD 39.3 vs 38 mm, EDV 160 vs 169 ml, ESV 60.6 vs 54.8 ml, EF 54.1% vs 57.8%, SF 27.6% vs 31.2%). It is concluded that exercise training raised the effort capacity in patients with old myocardial infarction, mainly through peripheral mechanisms, LV systolic function being unchanged. It is also important that exercise training have not any detrimental effect upon LV systolic function and consequently exercise training programmes can be applied and can be useful also in patients with old myocardial infarction and impaired LV systolic function.

Adult↗
PubMedDate not supplied

Ischemic preconditioning during successive exercise testing.

It was suggested recently that ischemic preconditioning can occur in clinical practice. We investigated this hypothesis in 26 patients with old myocardial infarction (MI) or stable angina pectoris, subjected to two successive exercise testings at 1 hour interval. The ST depression was significantly lesser during the second exercise testing (1.83 +/- 0.12 mm, vs 1.02 +/- 0.14 mm p < 0.01) at the same double product (DP) (24.877 +/- 1206 vs 24.711 +/- 1152 p > 0.05) and peak effort (76.92 +/- 6.63 w vs 75.96 +/- 6.27 w p > 0.05). The improvement was attributed to ischemic preconditioning.

Adult↗
PubMedDate not supplied

Transesophageal determination of SNRT and SACT in paroxysmal supraventricular tachyarrhythmias.

The paper tested the hypothesis that supraventricular tachyarrhythmias (SVT) could represent the first clinical manifestation of the sick sinus syndrome (SSS). Absolute sinus node recovery time (SNRT) and sinoatrial conduction time (SACT) were determined through transesophageal approach in 16 patients with paroxysmal SVT, but without bradycardic episodes between crises. The values considered normal were: SNRTa less than or equal to less than or equal to 1500 ms; SNRTc less than or equal to 525 ms; SACT less than or equal to 150 ms. SNRTa, SNRTc and SACT were normal in all subjects (SNRTa: 1077 ms; SNRTc: 400 ms; SACT: 111 ms) and suggest the absence of a notable sinusal disfunction in these patients. We concluded that SVT unassociated with bradycardia do not usually represent a manifestation of SSS. Consequently the administration of sinusal depressant drugs in such patients could be permitted without restrictions.

Cardiac Pacing, Artificial↗
PubMedDate not supplied

Comparative value of arm and leg exercise testing.

Arm exercise test (AET) is described as an alternative to the classical leg exercise test (LET). The value of these two types of exercise was studied in a group of 32 patients aged 34 to 65 years. The patients performed LET for several reasons and, after 24 hrs, AET under the same conditions. The effort level reached under LET was always greater than that achieved under AET and the calculated functional aerobic impairment (FAI) was 50% greater during AET thus supporting the idea that AET cannot be used instead of LET in determining the functional capacity (NYHA) of cardiac patients. However, AET remains useful for the determination of the occupational working capacity in certain occupational categories. The double product (DP) (or index tension time (ITT) calculated after AET represented 85% of the calculated value after LET. The results proved that MVO2 is similar for both LET and AET, but in the latter at lower levels of exercise (VO2). The LET-DP was greater than the AET-DP in 66.5% of our cases, thus suggesting that AET should be reserved for situations in which LET cannot be performed. This is also supported by the presence of ST depression during AET in only 66% of the 18 subjects with ST depression during LET and in five of the six patients without ST depression, DP-AET was lower than DP-LET.

Adult↗
PubMedDate not supplied

Dipyridamole-exercise association in the diagnosis of ischemic heart disease.

Dipyridamole-exercise ECG test (DET) was found to present a greater sensitivity than exercise or dipyridamole ECG test alone in detecting ischemic heart disease (IHD). A group of 39 patients with probable IHD and negative exercise test was investigated by i.v. dipyridamole administration. Eight subjects presented significant ECG changes. The remaining 31 subjects were submitted to a new exercise test which became positive in 7 subjects (23%). The percentage increases to 38% by taking into account the positive dipyridamole test. The authors concluded that DET substantially improve the diagnosis of myocardial ischemia in subjects with probable IHD and negative exercise test.

Coronary Disease↗